Individual
DR. NICOLE BERGER FULP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
215 MAGNOLIA DR N, TIFTON, GA 31794-4217
(229) 382-7996
(229) 386-4832
Mailing address
215 MAGNOLIA DR N, TIFTON, GA 31794-4217
(229) 382-7996
(229) 386-4832
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN014120
GA
Other
Enumeration date
06/28/2010
Last updated
06/28/2010
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